Eosinophilic esophagitis

Eosinophilic esophagitis
Other names	Allergic oesophagitis
Micrograph showing eosinophilic esophagitis. H&E stain.
Specialty	Immunology, Gastroenterology
Differential diagnosis	GERD, infection, celiac disease, hypereosinophilic syndrome, Crohn's disease, eosinophilic granulomatosis with polyangiitis[1]

Eosinophilic esophagitis (EoE) is an allergic inflammatory condition of the esophagus that involves eosinophils, a type of white blood cell. In healthy individuals, the esophagus is typically devoid of eosinophils.^[2] In EoE, eosinophils migrate to the esophagus in large numbers. When a trigger food is eaten, the eosinophils contribute to tissue damage and inflammation. Symptoms include swallowing difficulty, food impaction, vomiting, and heartburn.^[3]

Eosinophilic esophagitis was first described in children but also occurs in adults. The condition is poorly understood, but food allergy may play a significant role.^[4] The treatment may consist of removing known or suspected triggers and medication to suppress the immune response. In severe cases, it may be necessary to enlarge the esophagus with an endoscopy procedure.

While knowledge about EoE has been increasing rapidly, diagnosing it can be challenging because the symptoms and histopathologic findings are not specific.